To optimize your time with your provider it is helpful to have completed your intake form before your appointment. Please take some time to complete the forms and prioritize your goals for the visit. Arrive at least 15 minutes before your appointment so that we can enter some of the information into our records. This way we’ll be able to share more time with you and will be able to focus on what is most important to you.

Please click on appropriate link below to download the forms:

ADULT NEW PATIENT ESTABLISH CARE FORM & AGREEMENTS

for an “establish care visit” for adults.

PEDIATRIC/AGES 17 & YOUNGER NEW PATIENT ESTABLISH CARE FORM

for an “establish care visit” for children.

ACUTE OR URGENT VISIT INTAKE FORM

for short and simple visits for first-time patients.

RETURNING VISIT INTAKE FORM

for returning and follow-up visits after you have established care.

ANNUAL PHYSICAL EXAM INTAKE FORM

for annual exams. Please complete so that we are sure to have your most up-to-date information.

HEALTH COACHING PREP FORM

for tracking your progress toward your health coaching goals and identifying any changes you need to make to achieve them. Fill out before each health coaching follow-up session.

ADULT NEW PATIENT ESTABLISH CARE FORM & AGREEMENTS

PEDIATRIC/AGES 17 & YOUNGER NEW PATIENT ESTABLISH CARE FORM

ACUTE OR URGENT VISIT INTAKE FORM

RETURNING VISIT INTAKE FORM

ANNUAL PHYSICAL EXAM INTAKE FORM

HEALTH COACHING PREP FORM

Qigong with Lara Ferguson Diaz, L.Ac.

Heart Centered Meditation with Dr. Aneela Cox

2021 Winter Reboot